I got two fillings done back in August. One was done and the other done a week later. I've been going to this dentist for more than a year and they were in network.

I get the bill for the two fillings today and at the bottom they've hand written they are no longer in-network for my insurance which means the bill is nearly double what I thought I was going to be paying.

So my question is, why didn't they tell me they no longer took my insurance before they did the fillings? My last cleaning was on July 1 and those charges were in-network and by August 12 they were out of network, but didn't bother to tell me.

Guess I'll be finding a new dentist, but now I have to deal with the old dentist. I feel like I shouldn't have to pay the full amount. Am I wrong?

And the icing on the cake is the $8.12 finance charge they tacked on.

That's bullshit and I'd make a trip in to convey that message. Mention social media and I bet they'll settle for the old price. Then move on.

Yeah, that’s BS. They are obligated to tell you if they are in network or not. Also, if they recently became out of network, there should be a grace period in processing. Continue to raise a stink about it.

That happened with my wife last year. Our insurance plan covered cortisone shots in the back until about a week before my fifes Proceedure. The hospital dropped the ball in informing us of the rule change and sent us a $5,000 bill. It took a little bit of effort but the bill was erased from our debts.

Your insurance company should have sent you notice that you were no longer in network with that dentist. Mine did.
Still pissed me off but I’m not sure it’s necessarily the dentist’s job to know your insurance. You bought the policy, not him/her. They’ve got hundreds of patients to stay on top of, you have one insurance. Last time I tried to check with a doc’s office to see if they took my insurance, they politely told me to call my insurance myself to find out.

Nonetheless, I’m sure they’ll grace you something if you explain the time frame.

 
The fine print always says it is the patient's responsibility to determine network status before going to a practitioner. But I also agree, as a regular patient, they should have told you up front.

My dentist/physician always informs me of changes in network status.

I would tell the dentist to adjust the charges to match what you would have paid in-network. Or I would find another dentist.

Just call the office. Politely ask for the network rate,and the finance charge to be removed. Indicate you were happy with the work he did. Could be the front office staff.

quote:

Originally posted by henryaz:
 
The fine print always says it is the patient's responsibility to determine network status before going to a practitioner. But I also agree, as a regular patient, they should have told you up front.

True on both counts.

Dentists are evil. Everyone knows this.

I wouldn't take that. When you change insurance plans, you tell them. They should have done likewise.

quote:

Originally posted by henryaz:
 
The fine print always says it is the patient's responsibility to determine network status before going to a practitioner. But I also agree, as a regular patient, they should have told you up front.

True. But, I bet you can get them to take the in network rate. It may take some persistence, but the realities are on your side.

quote:

Originally posted by h2oys:

quote:

Originally posted by henryaz:
 
The fine print always says it is the patient's responsibility to determine network status before going to a practitioner. But I also agree, as a regular patient, they should have told you up front.

True on both counts.

The only problem here is they might not have known either if the timeframe was that short- usually the patient gets notification prior to the provider - certainly is that way for remittance advice. Sounds like both of you may have gotten screwed. It may be that they were in some sort of contractual arbitration as well, but give them the benefit of the doubt as you would hope they will give you. I think they’ll probably work with you.

So unfortunately I found out today I have the same problem as Skull Leader. I got a $700 bill about 3 weeks ago that included about $500 for a crown I got in December, 2019. I paid $560 up front before I even got the crown. I called and left a voicemail after I got the bill 3 weeks ago and never received a response. I keep forgetting to call but finally remembered today to call on my way home from work. I spoke to the office lady and we talked for almost 30 minutes and she told me they are now out of network just like Skull Leader has experienced. She says they have signs up saying as such but never verbally told anyone. My fault for not seeing/reading the sign, but I think the office folks should have explained that to everyone.

I also aired my feelings about the practice on top of billing issues during the call and told her I'm real close to finding a new dentist for many reasons, most of which are that they used to be a small office where you knew everyone there and they always spoke to you by name but about 2 years ago they moved to a much larger office and now you're just a number. They also have been charging people a $20 Covid fee for every patient before you even get in the office She said that is until the the end of 2020 She talked me down (at least for now) after offering to meet with me next Monday to discuss my bill. Depending on what happens with our meeting next week, I may be looking for a new dentist too.

So I called and talked with them today. The bill/invoice I received in the mail was their way of letting me know about the change with my insurance. They assured me that they would honor the charges as if I were still covered in network. They are just waiting for one more explanation of benefits and payment from my dental insurance and then they will bill me. I still have to find a new dentist.

I guess I over-reacted, but I was a bit miffed when I started this thread.

No you didn’t. It’s an interesting way to notify you..
More people need to realize the many ways in which insurance screws with us all. Used to be you’d be in network all year, now all of a sudden, contracts can drop like that.

Even if the provider is totally on top of it, insurance still tinkers... now, even though the dentist will still honor your bill as though you’re in network, they’ve lost a patient and the balance of the bill because they want to be stand up guys - and you’re still going to follow your insurance and walk away. So it’s a lose lose for the dentist, and you, the patient (like everyone else) will follow the carrot insurance extends to the next provider that will accept their crap reimbursements. Typically people end up with a bad taste in their mouth and mild suspicion for the next dental bill they receive (not you, specifically, just folks in general..and insurance put it there, but all most eventually remember is that so and so’s office misbilled you).

No, I’m not bitter much And I don’t blame anyone for following their insurance- that’s why we pay the premiums, but it is a sad thing for independent providers who are trying to do right by their patients and stay afloat. Watch for your EOB. You should get it in the mail before the dentist does, and you then can knowledgeably compare notes with your final bill.
I’m glad it worked out.

This message has been edited. Last edited by: irreverent,

My previous dentist notified me that I was now out of network when I showed up for an appointment. They said that for this visit, it would be treated as in an network this one time but all future visits I would need to pay up front, and wait for the insurance to reimburse me.

I went ahead with the appointment, then found a new in-network dentist for future visits and had all my records transferred to them.

[quote]No, I’m not bitter much And I don’t blame anyone for following their insurance- that’s why we pay the premiums, but it is a sad thing for independent providers who are trying to do right by their patients and stay afloat. Watch for your EOB. You should get it in the mail before the dentist does, and you then can knowledgeably compare notes with your final bill.
^^^^^^^^^^^^^^^^^^^^^^^^^
Glad you understand. I am friends with my dentist and pay out of pocket. He gives me somewhat of a discount. Dental insurance is EVIL. Medicare Advantage has now gotten into the dental market. The fees paid to dentists are more than deeply discounted.

That is why cosmetic dentistry is so attractive.

I hate dentists with a purple passion. I hate them so much that if hate had the force of physics, they'd wither and blow away when exposed to sun (and I'm sure some do). That said, if you find a good dentist, or one that doesn't make you beg for waterboarding as a relief, then stick with that dentist. If I have a dentist I trust, and for whom I don't spend every waking moment sticking pins in a effigy, then if he goes out of network, I'm going to keep paying cash, and stay with him, because it's far better than going somewhere else to a cheaper dentist who worked in the basement at CIA Langley, torturing rendition guests until their heads explode.

quote:

Originally posted by sns3guppy:.........because it's far better than going somewhere else to a cheaper dentist who worked in the basement at CIA Langley, torturing rendition guests until their heads explode.

Where do you think we all go for our last rotation before graduating from dental school?

The first rule of dentist club is...